Natural resistance, iron and infection: a challenge for clinical medicine

Bullen, J. J.; Rogers, H. J.; Spalding, Paul B.; Ward, C. Gillon

doi:10.1099/jmm.0.46386-0

Cited by 147 publications

(108 citation statements)

References 52 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…21,22 With regard to HCT, Pullarkat et al 16 reported that ferritin levels of X1000 ng/ mL were associated with a 2-fold higher risk of bloodstream infection compared with patients with ferritin levels of o1000 ng/mL in myeloablative HCT. In agreement with their finding, in this study, ferritin levels of 4700 ng/mL were associated with a 4-fold increased risk compared with the risk in patients with levels of p700 ng/mL.…”

Section: Discussionmentioning

confidence: 99%

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Kanda

Mizumoto

Ichinohe

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

Although fluoroquinolones or other antibiotics are commonly used to prevent bacterial infections after hematopoietic cell transplantation (HCT), because of the growing presence of multidrug-resistant microorganisms, it is important to identify patients who are more likely to benefit from antibacterial prophylaxis. To evaluate risk factors for early bacterial infection after allogeneic HCT, we retrospectively analyzed clinical data for 112 consecutive adult patients with hematological malignancies who received transplants without any antibacterial prophylaxis. The cumulative incidence of bacterial infection at 30 days after transplantation was 16%. Among various pre-transplant factors, only high serum ferritin (4700 ng/mL, 47 patients) and high C-reactive protein (CRP) (40.3 mg/dL, 28 patients) levels were significantly associated with the development of bacterial infection in a multivariate analysis (hazard ratio (95% confidence interval): ferritin, 4.00 (1.32-12.17); CRP, 3.64 (1.44-9.20)). In addition, septic shock and sepsis with organ failure were exclusively observed in patients who had high ferritin and/or high CRP levels. These results suggest that pretransplant serum ferritin and CRP levels can be useful markers for predicting the risk of early bacterial infection after allogeneic HCT. It may be prudent to limit antibacterial prophylaxis to patients with predefined risk factors to ensure the safety of HCT with the use of fewer antibiotics.

show abstract

Section: Discussionmentioning

confidence: 99%

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Kanda

Mizumoto

Ichinohe

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…In our patients, it was not possible to obtain clear information about transfusions. Increased amounts of ferritin in body stores severely damage or abolish normal bactericidal mechanisms, leading to overwhelming growth of bacteria and fungi [20]. Iron does not only adversely affect the phagocytic, chemotactic, and bactericidal capacity of neutrophils and monocytes, but also inhibits the activity of natural killer cells and macrophages [21].…”

Section: Discussionmentioning

confidence: 99%

Pretransplant serum ferritin level may be a predictive marker for outcomes in patients having undergone allogeneic hematopoietic stem cell transplantation

Şıvgın

Baldane²,

Kaynar³

et al. 2012

neo

View full text Add to dashboard Cite

Iron overload increases the risk of infections, veno-occlusive disease and hepatic dysfunction in post-transplant period. Our objective was to investigate the association of pre-transplant ferritin levels with complications and survival after allogeneic hematopoietic stem cell transplantation (alloHSCT).We retrospectively analysed 84 patients' data who had undergone allogeneic HSCT into two groups: patients with a serum ferritin level≥1000ng/ml, and patients with <1000 ng/ml at the time of HSCT.Cox-regression analysis showed that pre-transplant serum ferritin levels were significantly higher in patients who had at least one infectious event compared with those who had no any infectious event in the post-transplant 100 days (p<0.023). Overall survival (OS) and disease-free survival (DFS) rates were significantly higher in patients with a time-to-tx interval <12 months compared with group time-to-tx interval>12 months (p=0.002 and p=0.008 respectively). A higher risk of death was observed in high-ferritin group (hazard ratio=2.27, CI:1.01-5.09, p=0.023 for OS and hazard ratio=2.49, CI:1.12-5.53 p=0.039 for DFS). No significant effect on OS and DFS among groups was observed for variables conditioning regimen, gender and diagnosis. Acute GVHD was more common in patients with a ferritin level ≥1000 ng /mL, but this was not statistically significant (p>0.05). There was no statistical significance in both groups (ferritin≥1000ng /mL and ferritin<1000ng/mL) for relapse rates (p>0.05). Platelet and neutrophil engaftment day was not found statistically significant compared with both groups (p=0.273 and p=0.882, respectively).Pre-transplant ferritin levels may predict poor outcomes in patients who had undergone allogeneic hematopoietic stem cell transplantation.

show abstract

“…Recent studies have demonstrated that pretransplant iron overload, defined as elevated serum ferritin levels, is associated with worse OS, disease-free survival and non-relapse mortality (NRM) and with an increased risk of infection in patients undergoing allogeneic HSCT. [1][2][3][4][5][6][7][8][9] Liver dysfunction caused by iron overload 10 and neutrophil dysfunction with an increase in non-transferrin-bound iron levels 11,12 may have a negative impact on HSCT outcomes. However, most previous studies involved retrospective analyses of patients with heterogeneous diseases.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of pretransplant serum ferritin on the outcome of allogeneic hematopoietic SCT: a prospective cohort study by the Kanto Study Group for Cell Therapy

Tanaka

Kanamori

Matsumoto

et al. 2015

Bone Marrow Transplant

View full text Add to dashboard Cite

This prospective study aimed to investigate the influence of pretransplant serum ferritin levels on the outcomes of allogeneic hematopoietic SCT (HSCT). In total, 190 patients with acute leukemia or myelodysplastic syndrome were consecutively enrolled. The patients were divided into two groups: low-ferritin group (o 1000 ng/mL) and high-ferritin group (⩾1000 ng/mL). The primary end point was the cumulative incidence of infection within 100 days after HSCT, which was similar between the two groups: bloodstream infection, 35 vs 38%, P = 0.65; bacterial infection, 44 vs 41%, P = 0.68; and fungal infection, 6 vs 8%, P = 0.71. The 1-year adjusted probability of OS of the high-ferritin group was significantly lower than that of the low-ferritin group (76 vs 63%, P = 0.017). Using receiver operating characteristic curve, the threshold of pretransplant serum ferritin levels for bloodstream infection was 1400 ng/mL; the threshold for OS, EFS and non-relapse mortality was 1349 ng/mL. In conclusion, pretransplant serum ferritin levels of ⩾ 1000 ng/mL did not influence the incidence of infection but adversely affected OS after HSCT. A higher threshold of pretransplant serum ferritin levels may predict HSCT outcomes.

show abstract

Natural resistance, iron and infection: a challenge for clinical medicine

Cited by 147 publications

References 52 publications

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Pretransplant serum ferritin level may be a predictive marker for outcomes in patients having undergone allogeneic hematopoietic stem cell transplantation

Clinical significance of pretransplant serum ferritin on the outcome of allogeneic hematopoietic SCT: a prospective cohort study by the Kanto Study Group for Cell Therapy

Contact Info

Product

Resources

About

Natural resistance, iron and infection: a challenge for clinical medicine

Cited by 147 publications

References 52 publications

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Pretransplant serum ferritin level may be a predictive marker for outcomes in patients having undergone allogeneic hematopoietic stem cell transplantation

Clinical significance of pretransplant serum ferritin on the outcome of allogeneic hematopoietic SCT: a prospective cohort study by the Kanto Study Group for Cell Therapy

Contact Info

Product

Resources

About

Pretransplant serum ferritin level may be a predictive marker for outcomes in patients having undergone allogeneic hematopoietic stem cell transplantation